The annual Open Enrollment Period for insurance benefit changes begins Monday, May 4, 2020 and continues through Monday, June 1, 2020.  During this time you may make changes to your benefit plan elections.  In many cases, the next opportunity to modify your benefit coverage will be July 1, 2021.  Please review the following information carefully and submit any change requests to the Office of Human Resources by June 1, 2020.  Please visit the following links, most relating to the open enrollment, for more information.

2020 Open Enrollment Newsletter

2020 Amherst College Benefits Guide

Need Help Choosing Your Benefits? Use ALEX! the official Amherst benefits counselor, walks you through the process of picking your best benefits and provides easy-to understand explanations for any questions you have along the way. Visit to give ALEX a try.

Enrollment Meetings

Please join us at one of the upcoming benefit enrollment meetings by Zoom or by telephone, where you will have the opportunity to gather information and to discuss any benefits issues or changes you may be contemplating.


High Deductible Health Plan Meeting with HSA Provider, HealthEquity

Thursday, May 21, 2020, 12:00 PM to 1:00 PM

General Open Enrollment Meetings

Wednesday, May 13, 2020, 11:00 AM to 12:00 PM

Wednesday, May 27, 2020, 3:00 PM to 4:00 PM

To register for one of the meetings:

  • Follow this link to register for an upcoming Zoom meeting
  • You will be directed to the HR registration page (you will need to sign in to access the site)
  • Select preferred meeting date
  • You will receive an email with Zoom / conference call login details

 Quick Links

To elect, drop or make changes to health or dental coverage Blue Cross Blue Shield Application
To elect, drop or make changes to vision coverage EyeMed Application
To elect, drop or make changes to supplemental life insurance Life Insurance Change Form
To elect flex spending (the Amherst Plan) Amherst Plan Election Form
To elect a health savings plan (high-deductible health plan required) HSA Payroll Deduction Form
To Apply for Sliding Scale Consideration Sliding Scale Application

To Certify Domestic Partnership

Domestic Partnership Certification

Submitting Changes in the Time of COVID-19

All forms can be submitted to the Office of Human Resouces by campus mail (AC# 2204) or by US Post. Forms may be submitted by fax (413-542-2687) or electronically - scans and photos accepted. You may also complete and save fillable forms to your computer and then submit those files by email. We suggest adding your name to the file name and sending them from your Amherst College email address. Please send to

COVID-19 is not changing the deadline for submission -- please have all changes in by close of business, June 1, 2020.

Tax returns for sliding scale consideration may be submitted by email or via Zoom. Once documented by an HR representative, any images of the tax return will be deleted.  Sliding scale applications are due on July 1, 2020.

Health and Dental Information

Health Insurance Premiums, Individual

Health Insurance Premiums, Family

Dental Insurance Premiums, Individual and Family

Sliding Scale Application

Health Plan Information -- the SBC, the Summary of Benefits and Coverage is detailed, good for side-by-side comparisons. The Summary of Benefits is a readable, succinct guide to the plan.
HMO Blue SBC Summary of Benefits
HMO Blue Deductible Plan SBC Summary of Benefits
Blue Choice (point of service plan) SBC Summary of Benefits
Blue Care PPO (out-of-state residents, only) SBC Summary of Benefits
Blue Care Elect Saver with Coinsurance (high deductible plan) SBC Summary of Benefits
Dental Plan Information
Dental Blue Program 2 Summary of Benefits
Dental Blue Program 2 with Orthodontic Summary of Benefits

Dental Benefit Maximum Rollover

Find a Dentist, Doctor or Other Practitioner in the Blue Cross Networks

Prescription Medication Reference List 2020

Mail Order Pharmacy Brochure

Emergency Room Alternatives


HSA Factsheet

Amherst Plan Information and Forms

Amherst Plan Election Form

Amherst Plan Overview and Worksheet

The Amherst Plan Summary Plan Description

IRS Publication 502 -- Allowable Medical Expenses

IRS Publication 503 -- Allowable Dependent Care Expenses

Vision Insurance

EyeMed Summary of Benefits

EyeMed Application (to elect, drop or make changes to coverage)

Life and Long Term Disability Insurance Information

Summary of Benefits - Life and Long Term Disability Insurance

Life Insurance Change Form

Prudential Evidence of Insurability Form

General Announcements

Special enrollment rights related to Medicaid and the Children’s Health Insurance Program Reauthorization Act of 2009

HIPAA Notice of Privacy Practices

Medicare D Creditable Coverage Certificate 2020

CHIP NE Notice 2020